The medical term torticollis comes from Latin and means "twisted neck". In German, the malposition is called torticollis, as those affected can only keep their head tilted sideways. Torticollis can be permanent or only temporary.
Further information on torticollis and selected torticollis specialists can be found below.
The crooked neck severely restricts the patient's ability to move. Those affected suffer from impaired vision. Their communication with other people is severely impaired.
Torticollis is an extremely rare condition. It is either congenital or acquired. The cause of acquired torticollis can be, for example
can be the cause.
The incorrect posture is often not permanent, but occurs involuntarily. The neck can then no longer be straightened at all or only briefly with severe pain.
There are different forms of torticollis depending on the cause and the extent of the impairment can vary in severity.
Doctors also differentiate between the type of sideways tilt of the head:
In torticollis, only the muscles that are connected to the cervical spine are affected. This is crucial for the diagnosis of torticollis. If the neck muscles that originate from the patient's head are affected, it is not torticollis.
Torticollis can have various causes. Depending on the cause, a distinction is made between the following forms.
Muscular torticollis is congenital or develops during the birth process. It is usually clearly recognizable in newborns after 7 to 10 days. The child turns its head to the healthy side.
The cause of the early childhood malposition is a shortened head nodding muscle(sternocleidomastoid muscle). This muscle is one of the large neck muscles and is located on each side of the head.
In most cases of congenital muscular torticollis, the right sternocleidomastoid muscle is affected. Its muscle fibers are too tightly wrapped in connective tissue at the lower end. As a result, the shortened neck muscle cannot perform its function properly.
Congenital muscular torticollis often occurs together with other malformations such as
occur. In hip dysplasia, the hip joint socket is malformed.
Doctors believe that an unfavorable position of the child in the uterus is responsible for the deformities. One of the head muscles can also be damaged during birth if the baby's neck is exposed to too much pressure.
The bruising caused by an injury during birth heals over time. The swelling in the area of the neck muscle that occurs together with the muscular torticollis then usually also disappears. Both neck muscles can then work again with the same strength.
Osseous torticollis is caused by a bone malformation. Some vertebrae of the cervical spine are malformed or are positioned incorrectly in relation to each other.
Osseous torticollis is congenital (Klippel-Feil syndrome) or acquired. For example, an improperly healed fracture in the cervical spine can lead to torticollis.
Torticollis spasticus (also known as torticollis spasmodicus) is caused by neurological damage to the brain. It is also known as cervical dystonia. It is caused by a malfunction in the area of the brain that is responsible for the movement of the head muscles.
Spasmodic torticollis also causes pain.
Children are usually affected by this form of torticollis. Most of them lean their body to one side to compensate for the head misalignment. This can lead to further complaints.
Head misalignment can also have bacterial causes. Such an infectious torticollis is the result of
As the patient is in severe pain, he automatically adopts a protective posture. They tilt their head to the inflamed side.
Acute torticollis is usually the result of a cervical spine syndrome. Doctors use this term to describe all complaints associated with damage to the cervical spine.
Possible causes include an accident (whiplash injury) or signs of wear and tear.
Torticollis caused by scarring is the result of neck operations and injuries to the neck. A larger scar can lead to shortening of the neck muscle.
There is also ocular torticollis and oterogenic torticollis. In these cases, the sideways tilt of the neck is caused by impaired vision on one side or hearing loss in one ear. Patients voluntarily cause the head to tilt in order to be able to see or hear better.
Torticollis rheumaticus is caused by various types of rheumatism in the cervical spine. The affected person tilts their neck sideways in order to reduce their pain with this protective posture.
Some forms of torticollis disappear after a while, while others persist for life.
Torticollis is visible to the naked eye. The head is permanently or temporarily tilted to one side and sometimes even rotated. Some patients have pain in the area of the cervical spine. The affected muscle is also swollen.
People who suddenly notice this type of incorrect posture should definitely seek specialist treatment. Otherwise there is a risk of serious consequential damage.
For optimal treatment, the orthopaedic specialist must first identify the cause of the poor posture. To do this, they can use imaging techniques such as
are available. Electromyography is used to measure the electrical activity of the patient's muscles.
Sometimes it is also necessary to have your eyesight or hearing checked by an ophthalmologist or ear, nose and throat specialist.
In some forms of torticollis, a neck collar also helps © Pixel-Shot | AdobeStock
The treatment of torticollis depends primarily on the cause of the deformity.
Congenital muscular torticollis should be treated as soon as possible. If left untreated, it can lead to a chronic curvature of the spine(scoliosis). In addition, the sideways leaning half of the face may be restricted in its growth.
Affected children may only lie on their back or side. Physiotherapeutic exercises stretch the shortened head muscle and move the neck in the opposite direction in order to practice the natural head position.
If these therapeutic measures are not successful, surgery is the next treatment option.
The surgeon cuts the head nodule muscle at the base of the sternum. He then immobilizes the patient's head with a neck collar or plaster cast and immobilizes it for up to four weeks.
Spastic torticollis is treated with Botox injections. Botulinum toxin is a neurotoxin produced from certain bacteria. It is mostly used to inject wrinkles in cosmetic medicine. In the case of torticollis, it is intended to restrict the muscles in the affected region in their ability to move.
Alternatively, the patient can undergo surgery or brain stimulation.
Infectious torticollis is treated with antibiotics.
Although osseous torticollis can be treated surgically, this does not always completely eliminate the cause.
Patients with acute torticollis are fitted with a neck collar to correct the inclination. The patient is given ibuprofen, for example, to relieve the pain.
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